2016
DOI: 10.3390/ijns2030004
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A Novel Approach to Critical Congenital Heart Disease (CCHD) Screening at Moderate Altitude

Abstract: The American Academy of Pediatrics (AAP) has endorsed Critical Congenital Heart Disease (CCHD) screening using pulse oximetry nationwide, but, however, acknowledges that altitude may impact failure rates and alternative algorithms may be required at high altitudes. We therefore evaluated a modified screening protocol at an altitude of 6200 feet with the hypothesis that modifications could decrease failure rates. We evaluated 2001 well, newborn infants ě35 weeks gestation using a modified protocol, which includ… Show more

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Cited by 6 publications
(15 citation statements)
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“…High oxygen concentrations eliminate the need to consider fetal versus adult haemoglobin issues or variations in P 50 of different ethnic groups. The excellent study by Lueth et al 13 was performed at moderate altitude, and we do not know if their use of 26% oxygen would apply at higher altitudes. 3.…”
Section: Practical Considerationsmentioning
confidence: 88%
“…High oxygen concentrations eliminate the need to consider fetal versus adult haemoglobin issues or variations in P 50 of different ethnic groups. The excellent study by Lueth et al 13 was performed at moderate altitude, and we do not know if their use of 26% oxygen would apply at higher altitudes. 3.…”
Section: Practical Considerationsmentioning
confidence: 88%
“…Additionally, a study performed by Lueth and colleagues evaluated a modification to the AAP-recommended screening protocol with transient oxygen supplementation in newborns at moderate altitude. Their intent was to replicate sea-level atmospheric oxygen tension and induce pulmonary vasodilatation to potentiate the neonatal transition [11]. This group found an increase in specificity of screening with a reduction in false positive screens by providing transient supplemental oxygen to newborns with an indeterminate or borderline first screen at moderate altitude [11].…”
Section: Discussionmentioning
confidence: 99%
“…Their intent was to replicate sea-level atmospheric oxygen tension and induce pulmonary vasodilatation to potentiate the neonatal transition [11]. This group found an increase in specificity of screening with a reduction in false positive screens by providing transient supplemental oxygen to newborns with an indeterminate or borderline first screen at moderate altitude [11]. Because low oxygen saturation in CCHD is primarily caused by shunting of de-oxygenated blood to the systemic circulation, oxygen supplementation in clinical practice does not typically normalize the percent saturation to greater than 95% in hypoxemic CCHD.…”
Section: Discussionmentioning
confidence: 99%
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“…Several studies have assessed the differences and made recommendations for either adjusting the acceptable target saturations or providing a small amount of nasal cannula oxygen to compensate, referred to as the altitude adjustment (Guo et al, 2020;Lueth et al, 2016;.…”
Section: Themesmentioning
confidence: 99%